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MTB 1 Flashcards

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1
Q

What are PMS and PMDD - Presentation and difference

A

Premenstrual syndrome/dysphoric disorder

  • Women 20’s-30’s
  • Sx’s: HA, breast tenderness, pelvic pain, bloating
  • lack of energy, irritable
  • PMDD more severe - disrupts pt’s daily activities
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2
Q

Testing for PMS and PMDD

A

Menstrual diary

  • Sx’s for 2 consecutive cycles
  • Sx free in follicular phase (1st week)
  • Sx’s present in luteal phase
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3
Q

Tx for PMS and PMDD

A

Decrease caffeine, alcohol, cigs, chocolate

Severe - SSRI

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4
Q

What is Mittelschmerz and how does it present

A

Midcycyle pain
Women w regular menstrual cycle
Not on OCPs
Lateralizes to overy that produces mature ovum - unilateral pain

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5
Q

When does Mittelschmerz occur

A

2 weeks after start

At time of ovulation

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6
Q

Menopause lab levels

A

Increased FSH

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7
Q

TX for menopause

A

HRT = short term sx relief and osteoporosis prevention

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8
Q

CI to HRT

A

Estrogen dependent carcinoma

Hx of DVT or PE

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9
Q

What are the Estrogen dependent carcinomas

A

Breast

Endometrial

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10
Q

HRT can lead to what type of carcinoma

A

Endometrial

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11
Q

What conditions do we see menorrhagia

A

Endometrial hyperplasia
Uterine fibroids
DUB
IUD

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12
Q

What is menorrhagia

A

Heavy and prolonged menstrual bleeding

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13
Q

What is metorrhagia

A

Intermenstrual bleeding

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14
Q

When do we see metorrhagia

A

Endometrial polyps
Endometrial/cervical cancer
Exogenous estrogen administration

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15
Q

What is menometrorrhagia

A

Irregular bleeding

  • time intervals
  • duration
  • amount
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16
Q

Causes of menometrorrhagia

A

Endometrial polyps
Endometrial/cervical cancer
Exogenous estrogen administration
Malignant tumors

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17
Q

What is dysfunctional uterine bleeding (DUB)

A

Unexplained abnormal bleeding
Pts that are anovulatory
Ovary makes estrogen, but no corpus luteum to make progesterone
Continuous high estrogen

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18
Q

Test for DUB

A

R/O anovulation causes = hypothyroid, hyperPRL

EMB for women > 35

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19
Q

TX for EMB

A

OCPs

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20
Q

OCPs reduce risk for what

A

Endometrial cancer
Ovarian cancer
Ectopic pregnancy

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21
Q

What are types of emergency contraception

A

Copper IUD - place within 5 days

Hormonal contraceptive pills

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22
Q

What complication is ass’d with IUD

A

PID

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23
Q

What causes labial fusion

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A

Excess androgens

24
Q

MCC of labial fusion

Study These Flashcards
A

21-B hydroxylase deficiency

25
What is Lichen sclerosis?
White, thin skin from labia to perianal area | Chronic inflamm condition in anogenital region
26
Presentation of Lichen sclerosis?
Pruritis dyspareunia dysurai painful defacation
27
What does lichen sclerosis look like on PE
Porcelin white | Polygonal macules and patches w atrophic cigarette paper quality
28
Dx and tx of lichen sclerosis
Punch Bx to r/o cancer | Steroids
29
Cancer risk with lichen sclerosis
Post menopausal women have increased risk of cancer | Premalignant Vulvar SQCC
30
Lichen Planus Presentation and tx
30's-60's Violet, flat papules Tx steroids
31
Bartholin gland cyst location and presentation
``` Lateral sides of vulva - secrete mucus, become obstructed Pain Tenderness Dyspareunia PE: edema and deep fluctuant mass ```
32
Tx of Bartholin gland cyst
I&D | Culture fluid
33
What is normal vaginal pH
Below 4.5 (Lactobacillus maintains)
34
``` Bacterial vaginosis Pathogen Sx DX TX ```
Gardnerella Fishy odor, gray white d/c, NO inflammation KOH = clue cells Metronidazole or clindamycin
35
Candidiasis Sx DX TX
White, cheesy vaginal D/c KOH = pseudohyphae Miconazole, clotrimazole, econazole, nystatin
36
Trichomonas Sx DX TX
Profuse, green, frothy d/c, inflammation, pruritis KOH = motile flagellates Metronidazole + partner pH 5-6
37
Paget disease Presentation
Postmenopausal Caucasian women | Vulvar soreness and pruritus = red lesion w superficial white coating
38
Dx and TX for Paget Dz
Bx | Radical vulvectomy
39
What is adenomyosis
Invasion of endometrial glands into myometrium
40
Presentation of adenomyosis
35-50 Dysmenorrhea and Menorrhagia PE: Uterus that is large, boggy, globular
41
Risk factors for adenomyosis
Endometriosis | Uterine Fibroids
42
Test for adenomyosis
Most accurate is MRI
43
Tx for adenomyosis
Hysterectomy
44
What is endometriosis
Implantation of endometrial tissue outside uterus (endometrial cavity) MC location = ovary and pelvic peritoneum
45
Presentation for endometriosis
``` Women of reproductive age Dysmenorrhea = Abnormal bleeding Dyspareunia Dyschezia Infertility ```
46
what does endometriosis look like on direct visualization and on PE?
Rusty or dark brown lesions "Chocolate cyst" = ovary cluster of lesions PE: nodular uterus and adnexal mass
47
Tx for endometriosis
Analgesia OCPs or continuous progesterone Moderate - severe: Danazol or Leuprolide - decrease FSH and LH
48
Leuprolide continuous or pulsatile suppresses estrogen?
Continuous
49
PCOS Dx test
Pelvic US = BL enlarged ovaries w multiple cysts
50
PCOS labs
Testosterone (free) = High Androgens = High Estrogen = High LH: FSH > 3:1
51
Tx for PCOS
Wt loss OCPs Clomiphene Metformin
52
Premature Ovarian Failure Presentation
``` Women < 40yoa w Primary hypogonadism Amenorrhea Hot flashes Vagina/breast atrophy Anxiety Depression, Irritability ```
53
Causes of Premature Ovarian Failure
``` Chemo Radiation AI Turners Fragile X ```
54
Pathophys of Premature Ovarian Failure
Impaired follicular development causes decreased estrogen = loss of feedback inhibition causes HIGH FSH and LH FSH>LH
55
Dx for Premature Ovarian Failure
Preg test | PRL and FSH levels
56
When does endometriosis occur in relation to menses?
Cyclical pain starts 1-2 wks before menses and ends w menses Peaks 1-2 days before menses
57
MC site for endometriosis? Second?
MC - Ovary | 2nd - cul-de-sac = uterosacral ligament nodularity,

Gyn (3 decks)

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